•• u,me11erHEJ\.LTHIER specialty pharmacy .,_ YOU -E popular diets Multiple Sclerosis Managing MS symptoms is important for living your best life. Although there is limited evidence supporting a specifc diet to treat or manage symptoms, many with MS choose to follow certain eating patterns. Below are some of the most popular diets within the MS community. Before starting any diet plan, talk with your doctor or a registered dietitian. For more information on eating well with MS, check out the General Nutrition Recommendations resource.

Diet Details

• A low- diet emphasizing a very low intake. • Encourages whole grains, fruits and vegetables, fsh, shellfsh, and trimmed poultry. Swank Diet • Small quantities of red meat (3 oz/week) is only allowed after the frst year of the Swank Diet. • Rationale: A single study suggested the Swank Diet reduced relapse occurrences, disability, and mortality.

• Avoid all foods that contain gluten. Gluten is a protein found in , rye, barley, and their products. • Gluten can also be found in products that were processed in the same areas as gluten-containing foods. • Naturally gluten-free foods include fruits, vegetables, meat and poultry, fsh Gluten-Free Diet and seafood, dairy products, beans, and nuts. • Rationale: Many studies show that similar antibodies may be elevated in both MS and celiac disease. Those with celiac disease are prescribed a strict gluten-free diet, therefore it is reasonable to assume a gluten-free diet may be benefcial for those with MS as well.

• Encourages a diet rich in whole grains, vegetables, fruits, legumes, olive oil, and fsh. Mediterranean Diet • Limits saturated fat, red meat, poultry, dairy products, and processed food. • Rationale: May lower infammation.

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Diet Details

• A high-fat, very low carbohydrate diet. Ketogenic Diet • Rationale: May reduce infammation and slow down cell damage.

• A high-protein, high-fber diet emphasizing the dietary patterns of our paleolithic ancestors. • Includes fsh, lean meats, fruits, vegetables, and healthy . Eggs, nuts, and seeds are also included. Paleo Diet • Processed foods are restricted, including refned white sugar. Dairy products, wheat, grains, legumes, potatoes, and refned vegetable oils, like canola oil, are also excluded from this diet. • Rationale: May improve fatigue symptoms.

• A modifed Paleo Diet. • Includes meat and fsh, vegetables (particularly green leafy vegetables and sulfur-containing vegetables), brightly colored fruits, omega-3 fats, a small amount of gluten-free grains (2 servings or less per week) and supplemental products, like nutritional yeast, kelp, and spirulina.

Wahl’s Protocol • Excludes gluten-containing grains, dairy products, eggs, legumes, nightshades, sugar, and processed foods. • Includes lifestyle modifcations involving stretching, exercise, neuromuscular electrical stimulation, and stress reduction. • Rationale: Current research shows fatigue lowering benefts for Secondary Progressive MS.

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